Depression is a mental illness that affects around one in 10 people, but help is at hand.
Most people feel tired, sad or under the weather occasionally and experiencing a range of emotions is a normal reaction to life’s challenges. However if you struggle to shake your low mood and have intense feelings of sadness for any length of time, you could be suffering from depression.
Depression is a common mental health condition that often feels all-consuming and at its most severe can be life-threatening, but there are a number of treatment options available and help is at hand.
Ben Thornley, a qualified therapist from Glyde.co online therapy, looks at depression symptoms, causes and treatment options:
What is depression?
While most of you will have experienced spells of feeling sad or low in mood and perhaps even anxiety, worry or feelings of panic, these feelings will usually lift within a few days or a couple of weeks. But if your feelings of intense sadness just won’t budge, you could be suffering from depression.
Depression is very common. At any one time in the UK, about three per cent of men and nearer to four per cent of women will have depression, and according to figures from the Office of National Statistics (ONS) these numbers have doubled since the start of the COVID-19 pandemic.
A diagnosis of clinical depression will only usually be made if a person’s symptoms are more persistent and – along with the low mood – the person experiences a range of additional symptoms, listed below. However there are a number of lifestyle changes and things you can do to help yourself before it gets to this stage.
15 depression signs and symptoms
Symptoms of depression are usually a combination of psychological feelings and physical symptoms and often include one or more of the following:
- Feeling low
Common psychological symptoms of depression include intense sadness and low mood. It’s quite common for people with depression to lose their lust for life and stop being able to gain enjoyment or pleasure out of even simple things.
- Anxious thoughts
Symptoms of depression and anxiety often go hand in hand. One can lead to or be the cause of the other, for example, feeling anxious about going outside can mean that you become socially isolated and lead a very restricted life which can trigger depression. It’s thought that up to half of people with anxiety have depression and vice versa.
- Feeling irritable
While most people experience a short temper every now and then, if you are quick to become irritable and small things make you feel angry or annoyed this may be a sign of depression.
- Loss of interest
It is also common for depressed people to experience a loss of interest in things, a lack of motivation, or to find it difficult to enjoy the things they normally like doing.
- Feeling helpless
Feelings of helplessness, worthlessness or hopelessness are also common in depression, and it can be hard for people to make seemingly simple life decisions.
With severe depression, it can be common for people to question whether life feels worth living and to have thoughts of suicide or harming themselves.
- Changes to your eating habits
Changes to your eating habits such as eating a lot more or much less than usual and subsequent weight changes are a common symptom of depression. If you are not consuming enough food, this can also further exacerbate your low mood and lead to a continuing spiral of negative thoughts and feelings.
- Lack of energy
If you are suffering from depression it’s quite common to experience a complete loss of energy and to have no motivation or energy to carry out normal tasks.
- Sleep problems
One of the first telltale signs of depression is sleep issues or changes to your sleep patterns, and people with depression often report having trouble falling asleep, staying asleep, or sleeping too much – all of which can contribute further to the cycle of negative thoughts and feelings.
- Behavioural changes
Some people may experience noticeable behavioural changes when they experience depression, including speaking or moving slower than usual, lack of eye contact and stooped shoulders.
- Diminished sex drive
It is quite common for people to experience a low libido and lose interest in sex and intimacy during a period of depression. Conversely, some people also become fixated with sex and want to have more in order to counteract their low mood.
- Physical discomfort
Depression can impact you physically and many sufferers report unexplained aches and pains and general discomfort.
- Social isolation
Depression can have a significant impact on social functioning, leading to increased social isolation, spending less time with your friends or neglecting hobbies and interests, struggling at work, and having difficulties with your family or home life.
- Low self-esteem
People with depression often struggle with self-esteem and feel negative about themselves. Depression may be more common among those who are particularly self-critical or have low self-esteem.
- Feeling emotional
When people are depressed and struggling with unresolved emotions they can sometimes be tearful, or experience dramatic mood swings including outbursts of extreme sadness or rage.
Causes of depression
People can get depression for lots of reasons. Low mood can be triggered by any problematic or upsetting life event. Depression is more likely to occur if two or more of the following challenging life events occur at the same time, or within a short time of each other:
- Death or loss
The loss of a loved one through bereavement or a relationship breakdown and divorce can lead to depression.
- Financial worries
Losing your job and/or money worries can lead to feelings of depression as your finances are clearly linked to your sense of security.
- Addiction and substance abuse
People with substance abuse problems often suffer from depression too, as drugs and alcohol can work as a temporary balm but ultimately aggravate depressive symptoms.
Those with a family history of depression may be more likely to experience depression themselves.
- Health issues
Other contributory factors to depression can include old age, physical illness and serious medical conditions.
People who have experienced some form of trauma including emotional, physical or sexual abuse have a higher risk of developing depression.
- Major life changes
Any major life shift which upsets the status quo and feels stressful or unsettling can lead to depression including moving house, starting a new job, having a baby, getting married, getting divorced, your kids moving out and even retirement.
- Relationship conflicts
Various relationship conflicts can lead to feelings of depression including being bullied, being unhappy at work, disputes with your neighbours, or issues with personal or professional relationships.
- Social isolation
Social isolation can contribute to low mood and depression, while conversely loneliness and feeling alone can also make it feel harder to reach out to others and ask for help.
- Downward spiral
Another common experience people talk about is a ‘downward spiral’ of events in which one such event (such as a relationship breakdown) leads to a change in lifestyle (for example, becoming less sociable or drinking more) causing you to feel worse and become depressed.
How is depression diagnosed?
There is no single test to diagnose depression. However, your GP may make a diagnosis of depression based on your symptoms and a psychological evaluation.
You may be asked to fill out a questionnaire to help work out if you are depressed and the severity of your symptoms.
Depression is only usually diagnosed when symptoms have been experienced every day, throughout the day, for a period of over two weeks.
There are many different types and classifications of depression. For example, the severity and extent of depression may be described as follows:
- Mild depression: having some impact on daily life.
- Moderate depression: having significant impact on daily life.
- Severe depression: when it is nearly impossible to get through your day-to-day life.
Depression may in addition be classified in a way that describes the type of depression. For example:
- Recurrent depression:when depression comes back more than twice.
- Chronic depression: long term depression that has lasted more than two years (you may also hear this called persistent depression or dysthymia).
- Seasonal depression: a depression that is linked to the seasons such as during the darker winter months.
- Reactive depression: depression that it triggered by a life event such as a bereavement or redundancy.
- Pre or post-natal depression: when symptoms occur during or after pregnancy.
- Manic depression: also known as bipolar disorder when periods of depression are mixed in with periods of abnormally elevated or high mood.
- Psychotic depression: depression includes psychotic symptoms such as hallucinations or delusions. This is a severe type of depression.
How to treat depression
Many people are hesitant to ask for help when they are experiencing depressive symptoms, but sharing your feelings and accessing help is an important first step in getting better. The most common treatments for depression include talking therapy and antidepressant medication:
✔️ Talking therapies
Talking therapies can be effective in helping to overcome depression, such as:
- Cognitive behavioural therapy(CBT)
- Interpersonal therapy
- Psychodynamic psychotherapy
- Dialectical behaviour therapy
The most common ‘first-line’ treatment for depression is CBT, which has been around since the 1960s and evidence shows that it is effective in helping people overcome their depression. It works by helping people to understand and make sense of their thoughts while effectively managing their behaviour in ways that overcome their low mood. For example, CBT can help you learn how to overcome negative thoughts which can help you to tackle feelings of hopelessness.
❗ Your GP can refer to your local Community Mental Health Team for CBT. Some CBT techniques can be learnt through online courses.
✔️ Antidepressant medication
If talking therapies are not, by themselves, effective in overcoming the depression, your GP (or psychiatrist) may consider prescribing an antidepressant medication. There are lots of different types of antidepressant medication, some of which have been around since the early 1950s.
Most antidepressants work by changing the brain’s activity, specifically working to increase or decrease the action of chemicals known as neurotransmitters. Nowadays, the most commonly used antidepressants are known as Selective Serotonin Reuptake Inhibitors (SSRI’s). One such medication is fluoxetine (often known as Prozac).
Your GP or psychiatrist will follow evidence-based guidelines when prescribing medication for you, based on your specific individual needs. He or she should ensure that you are fully aware of how these drugs work, how long they may take to become effective, any side-effects you might expect from taking the drugs, and any risks involved.
Antidepressant medications typically take three to four weeks to become fully effective. Your doctor may increase or decrease the dose according to your response to the treatment and any side effects you are experiencing. Treatment usually continues for a number of months and sometimes longer to ensure that you are fully recovered before decreasing and stopping the medication. You should always discuss stopping or making any changes to your medications with your doctor rather than adjusting them yourself.
Community mental health team
Your GP is able to recommend the most appropriate treatment for you, including prescribing medication as required. However, if your symptoms are particularly severe and include thoughts of harming yourself or suicide you may be referred to a specialist team, often known as a community mental health team, or adult mental health team. You may also be assessed by a psychiatrist, which is a medical doctor specialising in mental health problems.
Other depression treatment
If someone doesn’t respond to treatment or when depression is particularly difficult to treat, psychiatrists and other mental health professionals (typically community psychiatric nurses, psychologists and social workers) have a range of approaches that they can try including different psychological therapies (talking therapies), medications and – on rare occasions – electroconvulsive therapy (ECT) – electric shock treatment. People with severe depression and who are felt to be at a high risk of harming themselves may be admitted to a psychiatric hospital for treatment and support.
Natural depression treatments
St John’s wort is available over the counter as a herbal antidepressant. Many people have found this herbal supplement helpful in treating their depression but it’s important to know that it is not included in any official health guidelines for treating depression. This is because larger scale medical studies haven’t proven its effectiveness and there are concerns regarding its safety due to its interactions with other medications and the side-effects it can cause. You should always tell your doctor if you are taking St John’s wort or any other herbal supplements.
Other alternative treatments such as acupuncture, aromatherapy, massage and meditation can be helpful in providing a sense of wellbeing in people who feel depressed but there is insufficient evidence to claim they can treat depression.
Why some people get depression and others don’t is still largely unknown. There is often a genetic link and depression can run in families. It’s thought that our environment and life events play a large role and potentially if we can look at the way we deal with stress in our lives, then we may be able to prevent some types of depression or to reduce the severity if we are affected.
There are many lifestyle practices that can help to lift your mood and improve the way you are feeling. They may play a role in preventing depression. Here are some common ones:
There is good evidence that being active regularly helps to improve mood. It also aids sleep, improves energy levels, concentration and memory. The recommended amount per week is 150 minutes of moderate intensity exercise which is one that makes you feel a little out of breath whilst you do it; brisk walking is perfect.
The extent to which diet can prevent depression is still being researched but there is some evidence that a mediterranean diet may help. Omega-3 supplements had been suggested as potentially useful but further research is needed before this can be confirmed.
Learning to pay attention to your thoughts and feelings and to the world around you can help you to understand yourself better and therefore be more alert to when you feel stressed or anxious. Meditation can enable you to take early action and potentially prevent a drop in your mood.
What to do if someone else is depressed
If you are concerned that a friend or family member might be depressed, be prepared to listen to them. Simply being listened to when we have a problem can be one of the most important ways in which people feel helped and supported.
Simply being listened to can be one of the most important ways in which people feel supported.
Listening is often enough to stop that ‘downward spiral’ and can help someone begin to feel better. If you are particularly worried about someone, you might gently recommend that they visit their GP.
If you are concerned that someone you know might be at risk of suicide or self-harm, don’t hesitate to share your concerns with others; tell their GP or a family member, and ensure that there is someone supporting them at all times until appropriate professional help is available.
What to do if you are depressed
If you have any concerns about your mental health, get help. Your GP is probably the best place to start. He or she will be very familiar with the kind of symptoms you describe and will non-judgmentally and sympathetically recommend the best course of action for you.
It is important that you acknowledge to yourself that you have a problem, and that you avoid judging yourself negatively. Remember, at least one in 10 of us will have depression at some point in our lives, so you are not alone, and you have nothing to be ashamed of, so be kind to yourself.
Further help and support
If you think you (or someone close to you) might be depressed or have any concerns about your mental health, the first port of call should be your GP. For additional support, try one of the following resources:
- Shout: Text ‘SHOUT’ to 85258 if you are struggling and a crisis volunteer will text you back. It’s completely free 24/7.
- Anxiety UK: a charity which specifies in helping those suffering from anxiety.
- The Samaritans: a charity providing support to anyone in emotional distress.
- Mind: making sure no one has to face a mental health problem alone.
- CALM: helping to reduce stigma and reduce rates of male suicide.
- Papyrus: contact for help and advice around thoughts of suicide.
- co: telephone and video calling therapy sessions.